Postpartum Depression: Ambivalence as a Risk Factor by Diana Lynn Barnes, PsyD., MFT Ambivalence about the maternal role is one of the presenting psychological risk factors in the onset of a postpartum depression. As clinicians working with women and their families around issues of pregnancy and birth, it is of critical importance that we are able to identify risk factors that can potentially lead to a disruption in the developing attachment between mother and infant.. The birth of a baby acts as a catalyst for a new mother’s remembrances about herself as a child. She brings to this event a wealth of unrevealed and unconscious information regarding her relationship with her own mother. The profound emotional experience of pregnancy and birth gives life to the memories of her earliest experience along with sensations, feelings and stored impressions. An emotionally unsatisfying and difficult relationship with her own mother may leave a woman feeling isolated and believing that she lacks the necessary coping skills to nurture her newborn. Mothers with postpartum depression tend to have significant doubts about their competency and efficacy. This is often a psychological outcome of ambivalence about their maternal role. Generally, this ambivalence stems from worries about their capacity to provide “good enough mothering.” They express grave concerns about their developing attachment relationship with their infants, and a profound fear that they may not have the emotional sustenance to be appropriately responsive, adequately attuned, and nurturing enough to meet the ongoing demands of their newborn. These kinds of feelings often leave new mothers vulnerable to a downward emotional spiral of hopelessness and despair with serious implications for...

A Closer Look: Understanding Mood Disorders by Diana Lynn Barnes, Psy.D, MFT “My baby had been crying for an hour. I felt nauseous. I had a 4-year-old in the next room, a screaming baby, and I felt myself unraveling away from my backbone. I started to shake. The quivering came from the deepest part of my soul, a place that you’re only aware of when you’re about to die. I needed to throw up, but I couldn’t get out of bed. I tried to sit up, but my eyes couldn’t see,, and I was dizzy. I felt scared. I thought I had made a horrible mistake. I didn’t want to take care of this baby.” In recent years, there has been increasing public awareness and concern about the necessity to educate and inform women and their families about their risks for a postpartum mood disorder. Research indicates that women are more vulnerable for developing a mood or anxiety disorder in the months surrounding birth than at any other time in their life (O’Hara, 1999). Fifty to 80 percent of mothers will experience some change in their mental health within the first year after delivery. Approximately 10 to 15 percent of these women are at risk for postpartum depression with potentially serious consequences for themselves, their families, and their newborns—the most devastating being suicide and infanticide. There is a critical need for early assessment and effective treatment. When ignored, the symptoms of a postpartum depression are far more likely to exacerbate, to become treatment-resistant and cyclical in nature with deleterious repercussions for the developing attachment relationship between mother and child....

Perinatal Depression and Anxiety By: Diana Lynn Barnes, Psy.D., LMFT There is no more profound transition in the life of a woman than her passage into motherhood. It touches us at so many different levels – physiologically, emotionally, psychologically and even spiritually. With motherhood comes a pronounced shift in our internal sense of us in the world. This psychological metamorphosis often feels like a crisis of identity as new mothers try to adjust to the sudden and dramatic change in their lives. It can often seem as though we are teetering between two worlds – the familiar world we left behind – the world where routine, time, companionship and freedom were an expected constant – and the current world which, particularly during the first year postpartum, is unpredictable, routine-less, and certainly lacking in the freedom to move about our day without having to first consider the seemingly relentless needs and requirements of a newborn. In order to fully embrace motherhood, we need to mourn the life that appears to have been left behind so that we can create a successful balance between that life we knew and the eye-opening physical and emotional challenges of the first year postpartum. Our ideas about “good” mothers are embedded in social and cultural expectations and further complicated by the many myths that have a pervasive influence on how new mothers believe they should look and how they should feel. Societal messages about mothering as automatic and instinctive, beliefs that the initial bond with their babies must be instantaneous and magnetic leaves so many new mothers feeling discouraged and disappointed when they come face...